Revision: Dec. 10, 2009, midnight
HB 1309-FN – AS INTRODUCED
2010 SESSION
01/05
HOUSE BILL 1309-FN
AN ACT requiring insurance coverage for infertility treatments.
SPONSORS: Rep. A. Perkins, Rock 14
COMMITTEE: Commerce and Consumer Affairs
This bill requires insurance coverage for infertility diagnosis and treatment up to the birth of a child.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
10-2225
01/05
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Ten
AN ACT requiring insurance coverage for infertility treatments.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Coverage for Infertility Diagnosis and Treatment. Amend RSA 415 by inserting after section 6-o the following new section:
415:6-p Coverage for Infertility Treatments.
I. Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance who are residents of this state, coverage for the diagnosis and treatment of infertility, including but not limited to diagnostic tests, procedures, and medications. Such treatment shall continue up to the birth of a child. For purposes of this section “infertility” means the presence of a demonstrated condition recognized by a licensed physician and/or surgeon as a cause of infertility; or the inability to conceive a pregnancy or carry a pregnancy to term after a year or more of unprotected intercourse. Coverage shall include, but not be limited to:
(a) Intrauterine insemination.
(b) In vitro fertilization (IVF).
(c) Frozen embryo transfer.
(d) Gamete intrafallopian transfer (GIFT).
(e) Zygote intrafallopian transfer (ZIFT).
(f) Intracytoplasmic sperm injection (ICSI).
(g) Seven completed egg retrievals per lifetime.
II. Coverage for the treatments in subparagraphs I(b), (d), (e), and (f) shall only be required if:
(a) The patient has used all reasonable, less expensive and medically appropriate treatments and is still unable to get pregnant or carry a pregnancy to term.
(b) The patient has not reached the maximum number of allowed egg retrievals.
III.(a) The benefits included in this section shall not be subject to any greater deductible than any other benefits provided by the insurer. The coinsurance required by the enrolled participant shall not exceed the amount allowed under the contract for the reasonable and customary charge for the services provided.
(b) The benefits included in this section shall be offered by providers and facilities that conform to standards set forth by the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists or other nationally recognized professional or government organizations. All guidelines and recommendations shall be based on scientific recommendations that have appeared in nationally recognized scientific journals.
(c) Nothing in this section shall limit the ability of an insurance carrier to select providers of these services provided that the requirements of subparagraph III(b) are met.
(d) The benefits included in this section shall be limited to those which have gained widespread acceptance in the United States and have been approved by those entities referred to in subparagraph III(b).
2 New Section; Coverage for Infertility Diagnosis and Treatment. Amend RSA 415 by inserting after section 18-t the following new section:
415:18-u Coverage for Infertility Treatments.
I. Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses, shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the diagnosis and treatment of infertility, including but not limited to diagnostic tests, procedures, and medications. Such treatment shall continue up to the birth of a child. For purposes of this section “infertility” means the presence of a demonstrated condition recognized by a licensed physician and/or surgeon as a cause of infertility; or the inability to conceive a pregnancy or carry a pregnancy to term after a year or more of unprotected intercourse. Coverage shall include, but not be limited to:
(a) Intrauterine insemination.
(b) In vitro fertilization (IVF).
(c) Frozen embryo transfer.
(d) Gamete intrafallopian transfer (GIFT).
(e) Zygote intrafallopian transfer (ZIFT).
(f) Intracytoplasmic sperm injection (ICSI).
(g) Seven completed egg retrievals per lifetime.
II. Coverage for the treatments in subparagraphs I(b), (d), (e), and (f) shall only be required if:
(a) The patient has used all reasonable, less expensive and medically appropriate treatments and is still unable to get pregnant or carry a pregnancy to term.
(b) The patient has not reached the maximum number of allowed egg retrievals.
III.(a) The benefits included in this section shall not be subject to any greater deductible than any other benefits provided by the insurer. The coinsurance required by the enrolled participant shall not exceed the amount allowed under the contract for the reasonable and customary charge for the services provided.
(b) The benefits included in this section shall be offered by providers and facilities that conform to standards set forth by the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists or other nationally recognized professional or government organizations. All guidelines and recommendations shall be based on scientific recommendations that have appeared in nationally recognized scientific journals.
(c) Nothing in this section shall limit the ability of an insurance carrier to select providers of these services provided that the requirements of subparagraph III(b) are met.
(d) The benefits included in this section shall be limited to those which have gained widespread acceptance in the United States and have been approved by those entities referred to in subparagraph III(b).
3 Coverage for Infertility Diagnosis and Treatment. Amend RSA 420-A:2 to read as follows:
420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-p, RSA 415:18, V, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.
4 Coverage for Infertility Diagnosis and Treatment. Amend RSA 420-B:20, III to read as follows:
III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-p, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.
5 Effective Date. This act shall take effect 60 days after its passage.
LBAO
10-2225
11/05/09
HB 1309-FN - FISCAL NOTE
AN ACT requiring insurance coverage for infertility treatments.
FISCAL IMPACT:
The Insurance Department states this bill will have an indeterminable fiscal impact on state revenue, county expenditures and local expenditures in FY 2010 and each year thereafter. The New Hampshire Association of Counties and the New Hampshire Municipal Association state this bill may increase county and local expenditures in FY 2010 and each year thereafter. There is no fiscal impact on county and local revenue or state expenditures.
METHODOLOGY:
The Insurance Department states this bill mandates insurance carriers include infertility treatments as part of policy benefits. The Department states mandated benefits generally increase the cost of coverage; however, the Department has no information on if and how employers might try to mitigate any increase in premiums resulting from the mandate of this additional coverage. If insurance premiums increase, Insurance tax revenue will increase. If employers take actions to mitigate any premium increase, tax revenue may stay the same or decrease. The Department is not able to determine the impact on state revenue, county expenditures, or local expenditures.
The Department of Administrative Services states the self-funded program is not subject to the insurance laws, thus it does not have a fiscal impact on the State health insurance program. Additionally, the State health insurance program for active and retired employees does provide coverage for infertility services.
The New Hampshire Association of Counties states this bill will increase county expenditures by an indeterminable amount. Expenditures will increase to the extent premiums paid by county employers increases as a result of the additional coverage for the diagnosis and treatment of infertility up to the birth of a child.
LBAO
10-2225
11/05/09
The New Hampshire Municipal Association states this bill will increase local expenditures by an indeterminable amount. Expenditures will increase to the extent premiums paid by local employers increase as a result of the additional coverage for the diagnosis and treatment of infertility up to the birth of a child.